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PA Day Camp Registration
We are looking forward to have you join our PA Day Camp!
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* Indicates required question
Student First Name
*
Your answer
Student Last Name
*
Your answer
Student Birthdate
*
MM
/
DD
/
YYYY
Gender
*
Male
Female
Other
Is Student a current student attending classes?
*
Yes
No
If not, has the child had art lessons before? Please specify:
Your answer
Which PA Day would you like to join?
*
Your answer
Does your Child have any Allergies?
*
Yes
No
Please Specify:
Your answer
Parent Full Name
*
Your answer
Parent Email
*
Your answer
Primary Phone Number
*
Your answer
Emergency Contact Name
*
Your answer
Emergency Contact Number
*
Your answer
Street Address
*
Your answer
City
*
Your answer
Postal Code
*
Your answer
Would you like to join our email list? (Monthly Art lessons to do from home, Art Tips)
*
Yes, include me!
Not at this moment
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